Dhar Chowdhury Sudipta, Oommen Anu Mary
Department of Gastroenterology, Christian Medical College, Vellore, India.
Department of Community Medicine, Christian Medical College, Vellore, India.
J Dig Endosc. 2020 Mar;11(1):3-7. doi: 10.1055/s-0040-1712187.
COVID-19, an infectious respiratory illness caused by the severe acute respiratory syndrome-corona virus 2 (SARS-CoV2), has now spread to multiple countries including India. The pace at which the disease spread in the last 4 months, since it was first recognized from China, is unprecedented. This review of the epidemiology of COVID-19 summarizes the burden of infection, transmission dynamics, and other related epidemiological features. While countries such as China, Italy, and the United States have particularly high-rates of infection, the disease is gradually spreading in India as well, threatening the health and economy of the country. Transmission in asymptomatic cases, early symptomatic phase, as well as limited access to testing in different settings are factors that have led to the rapid spread of infection. A large case series from China revealed that 81% of cases had mild symptoms, 14% had severe disease, and 5% were afflicted with critical illness. While the mortality in China was reported as 2.3%, Italy, with a high-proportion of elderly, reported a case fatality report of 7.2% due to higher infection and mortality rates among the elderly. Being a highly infectious disease, with a basic reproduction number between 2 to 3, COVID-19 is affecting a large number of healthcare workers, as evidenced by the fact that a sizeable portion of reported infections in the US included healthcare workers. Delivering health care for both COVID-19 affected individuals, as well those with other acute and chronic conditions, with limited access to healthcare facilities and services, are challenges for the health systems in low- and middle-income countries, which require immediate measures for health system strengthening across sectors.
新型冠状病毒肺炎(COVID-19)是由严重急性呼吸综合征冠状病毒2(SARS-CoV-2)引起的一种传染性呼吸道疾病,目前已传播到包括印度在内的多个国家。自首次在中国发现以来,该疾病在过去4个月中的传播速度是前所未有的。这篇关于COVID-19流行病学的综述总结了感染负担、传播动态以及其他相关的流行病学特征。虽然中国、意大利和美国等国家的感染率特别高,但该疾病也在印度逐渐蔓延,威胁着该国的健康和经济。无症状病例、早期症状阶段的传播以及不同环境下检测机会有限等因素导致了感染的快速传播。来自中国的一个大型病例系列显示,81%的病例症状轻微,14%患有严重疾病,5%患有危重症。虽然中国报告的死亡率为2.3%,但意大利老年人比例较高,由于老年人感染率和死亡率较高,报告的病死率为7.2%。作为一种高传染性疾病,COVID-19的基本再生数在2到3之间,它正在影响大量医护人员,美国报告的感染病例中有相当一部分是医护人员这一事实就证明了这一点。为COVID-19患者以及患有其他急慢性疾病的患者提供医疗服务,同时医疗设施和服务的可及性有限,这对低收入和中等收入国家的卫生系统来说是挑战,这些国家需要立即采取措施加强跨部门的卫生系统建设。